11/02/2015 10:03 GMT | Updated 13/04/2015 06:59 BST

Tackling the Tufts of Plug Surgery

The more eagle-eyed amongst you may have spotted my colleague Dr Greg Williams on the latest episode of Channel 5's Botched Up Bodies last Thursday. The programme followed Greg as he worked with a patient whose previously botched surgery had left him loathing his appearance.

The patient, 51-year-old Graham Ryder, was left with over 50 dent-like scars on his scalp after having an outdated plug surgery 29 years ago.

After losing his hair at the age of 22 - during a time Graham refers to as 'the decade of hair' - he turned to surgery to restore his crowning glory. During the procedure, hair was taken from the back of his head and inserted into his scalp in large clumps. He was initially pleased with the results but, when the rest of his hair began to thin, the plugs didn't recede and Graham was left with tufts of hair he likened to rows of carrots.

In a bid to get rid of the unsightly tufts he'd been left with on his otherwise bald head, 10 years ago Graham turned to electrolysis, which removed the hair, but left him with deep pitted scars across his scalp.

Understandably, Graham was left highly self conscious of the scars, which affected his confidence in both his private and professional life. In his job as a project manager, he found that he wore his hard hat more than necessary in a bid to disguise the scars.

Plug grafts are an archaic form of hair transplantation that was popular in the 1980s. They left many patients with results which were not aesthetically pleasing and many people have turned to today's refined techniques in order to rectify the appearance of their scalps.

The main problem with plug surgery is that there is too much hair in the grafts, and not enough density in between them, which is also prone to increasing with time. Many surgeons believed that additional surgery would allow them to fill in the gaps but, in many cases, the patient would run out of donor hair before this was an option.

After the initial assessment, Greg was happy to carry out a surgical scar excision procedure to reduce the appearance of the scars on Graham's scalp. In an operation lasting 3 hour, 50 dents were cut out to create smaller and neater scars. Graham was so happy with the results of the initial surgery that he has already had a second surgery, with the potential for more in future.

Hair transplant surgery has evolved significantly in recent years and there is now a range of sophisticated hair transplant options, from strip FUT and FUE, to ARTAS. All three of these techniques leave patients with much more refined results as increased levels of magnification allow us to harvest more efficiently, equivalent to 30 per cent more hair than before. We're now also able to transplant up to 5,000 grafts individually in one session, a noticeable increase on the plug technique.

Although hair transplant surgery has come on in leaps and bounds since plug grafts, it's still important to consider all options to ensure you're making the right decision for your needs, otherwise you could be left counting the cost of surgery in more ways than one.